Diabetic retinopathy is the leading cause of blindness in working age Americans, accounting for more than 12,000 new cases in the United States each year. The principle evidenced based treatment for proliferative diabetic retinopathy involves laser-mediated ablation, which fails to alter the molecular pathology of the disease, and as such, nearly half of patients require future treatments. Thus, our overall goal is to identify new targets for intervention at the molecular level that will lead to development of innovative, nondestructive therapies that address treatment of the cause of diabetic retinopathy, rather than the effect. The pathogenesis of this disease is caused by a combination of hyperglycemia and a reduction in insulin mediated signaling, which results in diabetic neurovascular complications through the induction of structural and physiological changes in the retina. The research proposed in this application is innovative, because it represents an entirely different approach to address the molecular basis of diabetic retinopathy, i.e. hyperglycemia-induced alterations in the translational control of gene expression. The central hypothesis is that the addition of O- linked N-Acetylglucosamine (O-GlcNAcylation) to serine or threonine residues of translation initiation factors mediates a shift from cap-dependent to cap-independent mRNA translation, resulting in an altered gene expression pattern that contributes to the pathophysiology of diabetic retinopathy. The hypothesis is supported by findings of elevated flux of glucose through the hexosamine biosynthetic pathway and O-GlcNAcylation of key components of the mRNA cap-binding complex, including eIF4E binding protein 1, eIF4G, eIF4A, and poly(A)-binding protein, under conditions of diabetes-induced hyperglycemia. Furthermore, herein we provide preliminary evidence that hyperglycemia favors the translation of mRNAs with internal ribosome entry sites, such as those encoding key vascular growth factors, in a manner that is dependent on the disruption of eIF4F complex assembly. During the mentored phase, the PI will acquire technical expertise from the laboratory of Dr. Gerald Hart on the methodology used to identify O-GlcNAcylation sites in proteins that control mRNA translation. Once the modified sites have been identified, the mechanisms through which hyperglycemia impairs eIF4F complex assembly will be defined. The mentored phase will also provide time for the candidate to receive guidance from Dr. Thomas Gardner to evaluate if preventing disruption of eIF4F complex assembly is sufficient to inhibit early preclinical phases of the pathogenesis of this disease in a mouse model of diabetes. With respect to outcomes, this project is expected to not only expand the PI's skills and systems of analysis, but will also identify novel mechanisms that link the metabolic abnormalities associated with diabetes to enhanced vascular growth factor expression in the retina. Identification of such mechanisms is significant because it is expected to validate new targets for the development of preventive and/or therapeutic interventions aimed at addressing the molecular basis of diabetic retinopathy and promoting healthy vision.